POSTOPERATIVE FATIGUE

Uncomplicated major surgery is followed by a pronounced increased feel ing of fatigue extending throughout the first month in about one-third of patients. Postoperative fatigue correlates with the degree of surg ical trauma but is not related to duration of general anesthesia and s urgery or to preoperative nutritional status, age, or sex. Fatigue als o correlates with postoperative deterioration in nutritional parameter s and impaired adaptability of heart rate during exercise. Furthermore , a postoperative decrease in muscle force and endurance is related to postoperative fatigue, whereas psychological factors are of minor imp ortance. These findings suggest postoperative fatigue to be mediated b y the endocrine-metabolic response to surgery, impaired nutritional in take, or immobilization, but the relative role of these factors remain s to be established. Until then, therapeutic measures against the deve lopment of postoperative fatigue should aim at reducing the surgical s tress response, effective treatment of pain to facilitate mobilization , and exercise to increase postoperative nutritional intake.